ASHA workers fail pregnant women of rural Kashmir

SRINAGAR: The much hyped Accredited Social Health Activists or ASHA, recruited to facilitate the pregnant women and reduce childbirth related mortalities in the villages, have failed to live up to their expectations in Kashmir.
Despite government of India spending a huge amount annually on their trainings, health experts said that ASHA workers hardly do their job owing to lack of accountability.
“Central government is wasting money on ASHA workers. I have never seen an ASHA worker accompanying a patient in Out Patient Department (OPD). They are supposed to come with a patient, check properly whether all her investigations are done, report to higher authorities if the patient is referred unnecessarily. But they don’t do it,” said a senior official at Lal Ded hospital, Shahnaz Taing.
National Rural Health Mission, which spends nearly Rs 20 crore annually on ASHA workers training and other incentives, terms an ASHA worker as a ‘mentor’ for a pregnant woman.
Their job includes – keeping a list of the pregnant women in the village, keeping track of their immunizations, accompanying the pregnant women to the place of delivery, counseling women on birth preparedness, breast feeding, the diet they should to take during and after pregnancy, basic sanitation and hygiene practice.
An ASHA worker has to motivate an expecting woman to deliver in district hospital and facilitate timely referrals. She has to make awareness about contraception and prevention of common infections of reproductive tract.
But except for keeping the record of pregnant women, ASHA workers forget rest of the duties.
“In a day, around 30 high risk pregnancy patients come to us. Some patients come up with juts 2 grams of haemoglobin left, while others come with very high blood pressure. And the sad part is they visit the hospital when they are in their 8th or 9th month of pregnancy. If the ASHA of their villages would have taken care of their health and counseled them. They would not land in Lal Ded in such terrible conditions,” said Humeira Noor, a registrar at Lal Ded hospital.
“On the time of delivery, we do see ASHAs, because they get incentives,” she said.
An ASHA gets Rs 1000 monthly for different activities.
A senior gynecologist at Lal Ded hospital said that if ASHAs would have been actively working in rural areas, things would have improved for better.
“But instead we get cases of young girls who have no concept of hygiene, and then they are diagnosed with problems like Poly Cystic Ovarian Disease (PCOD). We have patients who have developed infection in reproductive tract, because of the continuous use of contraceptives,” the doctor said.
Mission Director National Health Mission, Dr Yashpal Sharma, said that they take stock of ASHA workers’ work regularly.
“The central government is spending 20 crore rupees on their training. We have phone numbers of all the ASHA, and we do call them to take stock of their daily activities,” he said.
But many staffers at the NHRM office agreed that ASHAs play no role in counseling patients. “We call them and ask them how they are guiding patients. On phone they give positive response to every question. But on ground the results are not that good,” a group of employee said.

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